| Summary: | 碩士 === 長庚大學 === 管理學院碩士學位學程在職專班醫務管理組 === 99 === The aim of this study is to explore the association between medical seeking behavior and medical prognoses/consumptions among patients with type II diabetes mellitus (DM) in Taiwan. The findings will help decision makers to develop a more effective care model for diabetes care.
The study collected newly diagnosed type II DM samples from national health insurance database during 1999-2006 and conducted longitudinal analysis on their prognoses and medical utilizations until the end of 2010. A total of 117,115 newly diagnosed type II DM patients was found with an annually avarage toll of 19,519 patients during the study period. Variables from four dimensions, including medical seeking behavior, patient’s characteristics, provider’s characteristics, and outcomes of DM, were incorporated into the analysis. Chi-square test, Cox proportional hazard models, and multiple linear regression models were applied to explore the association among predictiors and medical outcomes/consumptions.
The analysis has demonstrated that incidence cases with low loyalty medical seeking behavior were likely to have high incidence of DM complications and mortality as well as high medical consumptions, such as outpatient visits, outpatient medical consumptions, inpatient length of stay, and inpatient medical consumptions, as opposed to patients otherwise. As conherence to the fact, the patients with DM complications were found to have higher medical consumptions than patients if not.
From the perspectives of preventive medicine, the primary strategy for diabetes care is to strengthen the role of family medicine and encourage patient’s loyalty of medical seeking behavior. The compliance of patient’s behavior will ensure the uniformaity of continuum care plan and will prevent unnecessary adverse drug reactions by ecessive multiphamacy. A positive proposition of future capitation payment system was made for increasing quality and benefits of diabetes care.
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